Comparing US States and Countries Life Expectancy Estimates

US life expectancy is shorter than in other high-income countries and varies widely between states. In a Milbank Quarterly article from the special issue, Disease Burden, Mortality, and Life Expectancy in the United States: What Can State Policymakers Do to Meet the Challenges?, Steven Woolf, MD, MPH, of the Virginia Commonwealth University uses data from the US Mortality Database and the United Nations to compare the life expectancy in US states and other countries. Woolf shows that in 2021, Hawaii’s life expectancy rate of 81 was comparable to high-income countries like the UK, Germany, and Greece, while life expectancy in West Virginia and Mississippi, age 71, resembled that of Bulgaria, Bangladesh, Azerbaijan, and Iraq. It also was lower than in impoverished countries such as North Korea and Syria.

The analysis also points out that US life expectancy disparities by state have widened over last 25 years. This gap has grown while political polarization, including variation in labor and immigration policies, across states has widened, with right-leaning states seeing worse life expectancy rates. Factors such as poverty, educational attainment, and higher rates of smoking and obesity also likely contribute to differing health outcomes. 

Data: United States Fertility and Mortality Database. Barbieri M, Winant C. U.S State Life Tables CSV + TXT 1941-2022. https://doi.org/10.7910/DVN/19WYUX. United Nations, Department of Economic and Social Affairs, Population Division (2024).